Der Nachweis von isolierten Tumorzellen in Knochenmark und Blut von Patientinnen mit primärem Mammakarzinom - Standardisierte Methodik und klinische Relevanz

Zusammenfassung

Trotz wesentlicher Fortschritte in der systemischen Therapie des Mammkarzinoms und deutlicher Prognoseverbesserung sind Rezidive nach oft langer Latenzzeit für diese Erkrankung charakteristisch. Ausgangspunkt für eine Fernmetastasierung sind der Regel isolierte Tumorzellen, die bereits früh im Verlauf der Erkrankung hämatogen disseminieren. Der Nachweis dieser minimalen Tumorresiduen (minimal residual disease, MRD) ist mit konventionellen bildgebenden Verfahren nicht möglich. Der immunzytochemische Nachweis isolierter Tumorzellen im Knochenmark ist die am besten validierte Methode, um Tumorresiduen zu detektieren. Die daraus gewonnenen Informationen über Prävalenz und Phänotyp der Tumorzellen lassen Rückschlüsse auf Tumorbiologie und individuelle Prognose zu, und könnten in Zukunft in der adjuvanten Situation zu einer Optimierung der Therapie führen. Die Detektion von minimalen Tumorresiduen nach Abschluss der Primärtherapie könnte die Beantwortung der von Patientinnen häufig gestellten Frage nach dem individuellen Erfolg adjuvanter Therapien in Zukunft erleichtern und Grundlage für die Einleitung einer „sekundär-adjuvanten Therapie” im Rahmen der onkologischen Nachsorge sein.

Schlüsselwörter

Mammakarzinom - disseminierte Tumorzellen - isolierte Tumorzellen - Mikrometastasen - minimale Tumorresiduen - adjuvant - sekundär-adjuvant

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